Table 1 Characteristics of all patients
characteristic
|
All
(n=522)
|
Male
(n=167)
|
Female
(n=355)
|
p-value
|
Age, years
|
|
49.54(12.06)*
|
50.09(11.25)*
|
0.619
|
Diagnosis(%)
|
|
|
|
0.085
|
DM
|
360(69)
|
126(75.4)
|
234(65.9)
|
|
CADM
|
47(9)
|
11(6.6)
|
36(10.1)
|
|
PM
|
115(22)
|
30(18)
|
85(23.9)
|
|
OLS(%)
|
|
9(5.4)
|
41(11.5)
|
0.026
|
Comorbidities(%)
|
|
|
|
|
Diabetes mellitus
|
36(6.9)
|
13(7.8)
|
23(6.5)
|
0.583
|
hypertension
|
54(10.3)
|
19(11.4)
|
35(9.9)
|
0.595
|
Chronic hepatitis B
|
24(4.6)
|
9(5.4)
|
15(4.2)
|
0.554
|
MDA5+(%)
|
70(13.4)
|
25(15)
|
45(12.7)
|
0.473
|
HB
|
|
130(120-146)
|
121(109-131)
|
0.000
|
PLT
|
|
194(143-254)
|
195(148-262)
|
0.508
|
EO%
|
|
0.6(0.1-2.6)
|
0.7(0.2-2.4)
|
0.653
|
NLR
|
|
4.52(3.09-7.82)
|
4.25(2.99-6.84)
|
0.323
|
ALB
|
|
34.9(31.3-38.4)
|
34.3(30.7-37.9)
|
0.272
|
AST/ALT
|
|
1.12(0.77-1.56)
|
1.30(1-1.82)
|
0.000
|
UA/CREA
|
|
5.3(3.93-6.51)
|
5.35(4.29-7.05)
|
0.062
|
TG
|
|
1.82(1.35-2.51)
|
1.97(1.45-2.79)
|
0.016
|
LDL
|
|
2.46(1.81-3.05)
|
2.29(1.68-3)
|
0.221
|
CK
|
|
110(52-703)
|
136(42-1156)
|
0.943
|
readmission within 1 year(%)
|
|
36(21.6)
|
67(18.9)
|
0.472
|
need for MV within 1 year(%)
|
|
15(9)
|
28(7.9)
|
0.671
|
deaths within 1 year(%)
|
|
21(12.6)
|
43(12.1)
|
0.881
|
*: mean (standard deviation)
Bold indicates statistical significance.
DM: dermatomyosis, CADM: clinically asymptomatic dermatomyosis, PM: polymyosis, OLS: overlap syndrome, MDA5: anti-melanoma differentiation-associated gene 5, HB: hemoglobin, PLT: platelet count, WBC: white blood cell count, EO%: percentage of eosinophils, NLR: neutrophil/lymphocyte ratio,ALB: albumin, UA: uric acid, CREA: creatinine, TG: triglycerides, LDL: low density lipoprotein, CK: creatine kinase, MV: mechanical ventilation.
Table 2 Clinical characteristics of patients across quartiles of AST/ALT ratio
characteristic
|
Group 1
(≤0.91)
|
Group 2
(0.91-1.26)
|
Group 3
(1.26-1.73)
|
Group 4
(>1.73)
|
p-value
|
N
|
133
|
128
|
131
|
130
|
|
Sex,Male (%)
|
58(43.6)
|
38(29.7)
|
44(33.6)
|
27(20.8)
|
0.001
|
Age, years (%)
|
|
|
|
|
|
≤40
|
31(23.3)
|
20(15.6)
|
28(21.4)
|
22(16.9)
|
0.205
|
40-60
|
85(63.9)
|
85(66.4)
|
74(56.5)
|
78(60)
|
|
>60
|
17(12.8)
|
23(18)
|
29(22.1)
|
30(23.1)
|
|
Diagnosis
|
|
|
|
|
|
DM
|
82(61.7)
|
87(68)
|
86(65.6)
|
105(80.8)
|
0.046
|
CADM
|
16(12)
|
12(9.4)
|
12(9.2)
|
7(5.4)
|
|
PM
|
35(26.3)
|
29(22.7)
|
33(25.2)
|
18(13.8)
|
|
OLS
|
11(8.3)
|
12(9.4)
|
16(12.2)
|
11(8.5)
|
0.681
|
Comorbidities
|
|
|
|
|
|
Diabetes mellitus
|
8(6)
|
11(8.6)
|
8(6.1)
|
9(6.9)
|
0.834
|
hypertension
|
13(9.8)
|
20(15.6)
|
11(8.4)
|
10(7.7)
|
0.144
|
Chronic hepatitis B
|
6(4.5)
|
3(2.3)
|
7(5.3)
|
8(6.2)
|
0.5
|
MDA5+
|
18(13.5)
|
17(13.3)
|
17(13)
|
18(13.8)
|
0.997
|
HB
|
132(122.5-144.5)
|
123(112-132)
|
120(111-131)
|
116.5(104.5-126)
|
0.000
|
PLT
|
192(140.5-233.5)
|
194.5(144-262)
|
195(154-261)
|
196(134.25-264.25)
|
0.714
|
WBC
|
8.07(6.2-10.63)
|
6.92(4.68-10.52)
|
5.89(4.49-8.05)
|
5.41(3.97-7.81)
|
0.000
|
EO%
|
0.3(0-0.9)
|
0.75(0.3-2.58)
|
1.6(0.3-3.5)
|
1(0.18-2.83)
|
0.000
|
NLR
|
4.28(3.15-7.72)
|
4.38(3.02-6.84)
|
4.03(2.99-6.41)
|
4.82(2.88-7.93)
|
0.278
|
ALB
|
36.2(33.55-39.05)
|
34.75(31.93-38.48)
|
34.3(30.9-38.3)
|
32.15(28.3-35.35)
|
0.000
|
UA/CREA
|
5(3.98-7.04)
|
5.24(4.36-6.58)
|
5.35(4.18-6.90)
|
5.62(4.32-7.30)
|
0.476
|
TG
|
1.92(1.37-2.78)
|
2.16(1.56-2.79)
|
1.77(1.37-2.4)
|
1.92(1.44-2.79)
|
0.032
|
LDL
|
2.86(2.3-3.52)
|
2.44(1.89-3.11)
|
2.24(1.64-2.77)
|
1.86(1.32-2.53)
|
0.000
|
CK
|
69(30.5-505.5)
|
106.5(41-1786.25)
|
177(67-1449)
|
146.5(59.75-992)
|
0.000
|
readmission within 1 year
|
19(14.3)
|
25(19.5)
|
26(19.8)
|
33(25.4)
|
0.163
|
need for MV within 1 year
|
7(5.3)*
|
6(4.7)*
|
10(7.6)
|
20(15.4)*
|
0.006
|
deaths within 1 year
|
9(6.8)*
|
11(8.6)*
|
14(10.7)*
|
30(23.1)*
|
0.000
|
Data are presented as n, n (%) for categorical variables and median (interquartile range) for continuous variables.
Bold indicates statistical significance.
DM: dermatomyosis, CADM: clinically asymptomatic dermatomyosis, PM: polymyosis, OLS: overlap syndrome, MDA5: anti-melanoma differentiation-associated gene 5, HB: hemoglobin, PLT: platelet count, WBC: white blood cell count, EO%: percentage of eosinophils, NLR: neutrophil/lymphocyte ratio,ALB: albumin, UA: uric acid, CREA: creatinine, TG: triglycerides, LDL: low density lipoprotein, CK: creatine kinase, MV: mechanical ventilation.
Bonferroni correction (0.05/6=0.0083):
need for MV within 1 year:
group 1 VS group 4 p=0.007*
group 2 VS group 4 p=0.004*
deaths within 1 year:
group 1 VS group 4 p=0.000*
group 2 VS group 4 p=0.001*
group 3 VS group 4 p=0.008*
Table 3 COX univariate analysis
variables
|
readmission within 1 year
|
need for MV within 1 year
|
deaths within 1 year
|
p-value HR
|
p-value HR
|
p-value HR
|
Sex
|
0.249
|
0.530
|
0.700
|
Age, years
|
0.077
|
0.042
|
0.017
|
≤40
|
|
|
|
40-60(1)
|
|
|
|
>60(2)
|
|
|
|
Diagnosis
|
0.028
|
0.035
|
0.093
|
DM
|
|
|
|
ADM(1)
|
|
|
|
PM(2)
|
|
|
|
OLS
|
0.102
|
0.148
|
0.078
|
Comorbidities
|
|
|
|
Diabetes mellitus
|
0.322
|
0.395
|
0.608
|
hypertension
|
0.353
|
0.785
|
0.801
|
Chronic hepatitis B
|
0.233
|
0.337
|
0.998
|
HB
|
0.519
|
0.062
|
0.386
|
PLT
|
0.419
|
0.598
|
0.377
|
WBC
|
0.05
|
0.631
|
0.962
|
EO%
|
0.017
|
0.001
|
0.017
|
NLR
|
0.514
|
0.000
|
0.000
|
ALB
|
0.842
|
0.000
|
0.000
|
UA/CREA
|
0.669
|
0.003
|
0.013
|
AST/ALT
|
0.003
|
0.005
|
0.000
|
≤0.91
|
reference
|
reference
|
reference
|
0.91-1.26(1)
|
0.225 1.454
|
0.781 0.857
|
0.657 1.221
|
1.26-1.73(2)
|
0.329 1.346
|
0.469 1.429
|
0.302 1.554
|
>1.73(3)
|
0.001 2.664
|
0.008 3.195
|
0.001 3.668
|
TG
|
0.011
|
0.049
|
0.000
|
LDL
|
0.152
|
0.029
|
0.149
|
CK
|
0.096
|
0.082
|
0.086
|
Bold indicates p<0.1
DM: dermatomyosis, CADM: clinically asymptomatic dermatomyosis, PM: polymyosis, OLS: overlap syndrome, MDA5: anti-melanoma differentiation-associated gene 5, HB: hemoglobin, PLT: platelet count, WBC: white blood cell count, EO%: percentage of eosinophils, NLR: neutrophil/lymphocyte ratio,ALB: albumin, UA: uric acid, CREA: creatinine, TG: triglycerides, LDL: low density lipoprotein, CK: creatine kinase, MV: mechanical ventilation.
Table 4 Cox multivariate regression analysis across quartiles of AST/ALT ratio
AST/ALT ratio
|
N (%)
|
unadjusted HR(95%CI)
|
p-value
|
adjusted HR(95%CI)
|
p-value
|
Mortality*
|
|
|
|
|
|
≤0.91
|
9(14.1)
|
reference
|
0.91-1.26
|
11(17.2)
|
1.221(0.506-2.947)
|
0.657
|
1.259(0.514-3.086)
|
0.614
|
1.26-1.73
|
14(21.9)
|
1.554(0.673-3.590)
|
0.302
|
1.814(0.757-4.35)
|
0.182
|
>1.73
|
30(46.9)
|
3.668(1.741-7.729)
|
0.001
|
3.423(1.481-7.911)
|
0.004
|
mechanical ventilation **
|
|
|
|
|
|
≤0.91
|
7(16.3)
|
reference
|
0.91-1.26
|
6(14)
|
0.857(0.288-2.550)
|
0.781
|
1.086(0.356-3.312)
|
0.884
|
1.26-1.73
|
10(23.3)
|
1.429(0.544-3.756)
|
0.469
|
2.231(0.791-6.294)
|
0.129
|
>1.73
|
20(46.5)
|
3.195(1.350-7.559)
|
0.008
|
4.172(1.498-11.621)
|
0.006
|
Readmission***
|
|
|
|
|
|
≤0.91
|
19(18.4)
|
reference
|
0.91-1.26
|
25(24.3)
|
1.454(0.794-2.662)
|
0.225
|
1.62(0.879-3.066)
|
0.120
|
1.26-1.73
|
26(25.2)
|
1.346(0.741-2.446)
|
0.329
|
1.935(1.020-3.673)
|
0.043
|
>1.73
|
33(32)
|
2.664(1.513-4.692)
|
0.001
|
3.670(1.968-6.844)
|
0.000
|
*HRs were adjusted by sex, age, diagnosis, OLS, EO%, NLR, ALB, UA/CREA, TG, CK.
**HRs were adjusted by sex, age, diagnosis, HB, EO%, NLR, ALB, UA/CREA, TG, LDL, CK.
***HRs were adjusted by sex, age, diagnosis, WBC, EO%, TG, CK.
Bold indicates statistical significance.
N: number, HR: hazard ratio, CI: confidence interval, AST: aspartate transaminase, ALT: alanine transaminase